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Nemont Long Distance / Online Sign Up

I WANT NEMONT LONG DISTANCE TO BE MY LONG DISTANCE PROVIDER.

I understand that by submitting this online form, I am selecting Nemont Long Distance as my long distance provider for the designated area(s) that I have selected below, and for the telephone number(s) entered below:

Select Areas for Nemont Long Distance

: InterLata/InterState (State to State Calls)
: IntraLata (In-State Calls)
: Both (All Long Distance Calls)

Your Name (as it appears on your phone bill)

First*
Last*

List Your Phone Number(s) You are Switching to Nemont & Email

Phone*
Secondary Phone
Third Phone
Email*

Mailing Address

Street Address*
Address Line 2
City*
State*
Zip Code*

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You may also download an Acrobat PDF version of this form, print, fill out and mail to: NEMONT LONG DISTANCE, PO Box 600, Scobey MT 59263-0600. You can also fax it to: 1-406-783-5639.